Arrhythmias & electrophysiology
Evolution of Tined Leadless Pacemaker Implantation: Patient Selection, Implant Volume, Center Characteristics, and Safety Trends
- Medicare claims linked to a manufacturer's device registration data
- random-intercept models
+1 more
- random-intercept models
Authors' conclusion
In Medicare patients with tined leadless pacemakers, cardiac perforation rates declined over time and were lower in those implanted by more experienced implanters. Variation in outcomes was more closely associated with implanters than facilities.
Study context
- Population
- Medicare patients implanted with a tined leadless pacemaker from 2017 to 2024implants, 19,446 (41.6%) were Micra AV
- Participants
- 46,698 patients
- Comparison
- Cardiac perforation rates over time and by implanter volume and facility characteristics
Main finding
As reported in the abstract
Cardiac perforation rates over time · 2017 to 2024
Adjusted Coefficient
−0.13, 95% CI −0.19 - −0.06, p-value<0.01
Further findings
| Outcome | OR (per additional 10 implants) (95% CI) | P value | |
|---|---|---|---|
| Cardiac perforation by implanter volume · higher implanter volume associated with fewer perforations | 0.93 (0.88–0.98) | P < 0.01 | |
| 0.512Odds ratio (log scale) |
Patient characteristics
- Mean age
- 80.4 years
- Charlson Comorbidity Index
- 4.7±3.4
Patient selection across providers and facilities
- Differences in patient characteristics across providers and facilities were observed; adjustment did not materially alter the associations between implanters and facility and perforation rates
Original publication
Evolution of Tined Leadless Pacemaker Implantation: Patient Selection, Implant Volume, Center Characteristics, and Safety Trends. Heart Rhythm. Published 16 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it